Last week, the government announced plans to develop a campaign to train one million people in Mental Health First Aid (MHFA) skills. This follows on from an announcement of a review into the Mental Health Act - official figures show that 63,622 people were detained under the Act in 2015-16, which is almost 50 per cent higher than the figure 10 years previously. The review will therefore aim to examine the causes of this rise and the continued disproportionate use of the Act in relation to Black, Asian and Minority Ethnic (BAME) people.
While the Government appears to be following through on the raft of mental health policies included in their manifesto, there is still much more they need to do to if they are to achieve their pledge of parity of esteem between mental health and physical health.
Business in the Community's (BiTC's) Mental Health at Work Report 2017, published in the run up to World Mental Health Day, has served to highlight some of the persisting issues when it comes to parity of esteem in the workplace. The report shows that there are increasing levels of discrimination for those experiencing mental ill health and a lack of services, facilities and training to support the mental health and wellbeing of staff. With 60 per cent of employees reporting having experienced work-related mental health issues, ensuring that appropriate wellbeing strategies, policies and supports are in place is crucial.
Responsibility for this lies with both policy makers and employers, and whilst more organisations are recognising this, much more needs to be done. As a peer who has worked towards legislative change in mental health, for example, with the Mental Health Act 2007, the Health and Social Care Act 2012 and the Care Act 2014, I believe there are two key areas - arguably easy wins - that the government should be prioritising to increase momentum and support culture change.
The first is to ensure that those experiencing mental ill health are protected against discrimination under the Equality Act 2010. Current legislation states that a mental health condition must last for at least 12 months for this to happen, therefore, many employees experiencing mental ill health for shorter periods will not be protected. The Health Secretary has spoken of his intentions to address this issue, however, the Mental Health at Work Report's finding that 15 per cent of employees face dismissal, disciplinary action or demotion after disclosing a mental health issue at work, surely underlines an urgency that his intentions need to be turned into actions sooner rather than later.
The same can be argued in regards to the introduction of legislation on mental health first aid provision in workplaces, which is another government pledge. If implemented, this would go some way to addressing training needs and helping to create workplace cultures where mental ill health is understood and employees are better supported on an ongoing basis.
However, achieving parity of esteem for mental and physical health would be diminished if we neglect to address issues around racial equality in mental health. The latest figures reveal that rates of detention across the whole adult population are over four times higher for black people, compared to white people, and around two times higher in the entire BAME population.
The BiTC report also reveals that, not only are BAME employees less comfortable talking about mental health, they are also less likely to consult their GP. Equally, research by Mind suggests that one in four BAME people experiencing mental ill health keep their problems to themselves, believing that no one they know would understand.
Whilst it is difficult to make conclusions as to the underlying causes without further research, it is clear that inequality in mental health is real and is bound up with race and ethnicity. The data published by the government last week has served to expose these inequalities. Using this type of information to link the Prime Minister's drive for racial equality and the government's pledge to work towards parity of esteem, will be key to ensuring that this is effectively achieved in the long-term.
Taking the population as whole, the increasing number of detentions under the Mental Health Act suggest that a growing number of people are reaching a crisis point before receiving the help they need. Therefore, there is clearly a need for more to be done in regards to prevention and we need to focus our efforts on raising mental health literacy, supporting early intervention and ensuring that people feel able to come forward to access support at the earliest possible opportunity. Only in this way can we improve mental resilience in our schools, universities and workplaces, and decrease the number of detentions.
Along with work being done by Mental Health First Aid (MHFA) England to improve mental health literacy, the government's commitment to train one million people in MHFA skills is a huge step in the right direction. These programmes give more people an awareness of the signs and symptoms of common mental health issues, and most importantly, the knowledge and confidence to access and direct others to the right support at the right time. Cultural change is realised in thought and word, so by empowering the general public to speak and think differently about mental health we can build a solid foundation for a more open, mentally healthier society and one geared towards prevention at every level.
The Prime Minister has stated her intention to tackle the 'burning injustices' in our society with wide-ranging social reforms. Any progress made among minority and marginalised groups with severe and chronic mental illnesses would serve her well as a measure of her success in mental health. However, to achieve this, more of the government's well-meaning words and intentions need to become actions - sooner rather than later.
Professor Lord Patel of Bradford is patron of MHFA England and a former Chair of the Mental Health Commission